Study of Amblyopia Recurrence in Eastern Uttar Pradesh

Background: To evaluate the various factors associated with recurrence of Amblyopia. Methods:In this prospective observational study, 100 patient’s diagonised anisometropic and strabismic amblyopia. All patients were undergone squint workup and were treated with optical correction, occulusion therapy or penalization. Patients were divided three groups - group 1 age (4-7 year) , group 2 age(8-12 year), group 3 age(13-17 year) . Patients were followed upto 12 month and various factors assessed which could be responsible for amblyopia and compared between three group. Results:Recurrence of amblyopia was seen in 24% of patients which was more in group 1 & mixed amblyopia type (statically significant p < 0.05). Recurrence of amblyopia was found to be patients independent of binocular vision and mode of treatment. Recurrence and its relation with length and dose of occlusion therapy were significant those who were weaned off 6 hrs patching as compared 2 hrs patching. Recurrence of amblyopia was found to be more in those who improved five lines as compared to two lines with statistically significant p < 0.05. Recurrence was more in first 6 month as compared to last six month during follow up. Conclusion: Recurrence is more commonly seen between the ages of 4-7 yrs and those who with mixed amblyopia should be closely monitored during follow up. Occlusion therapy should be prescribed weaning off, it should not be abruptly stop. Since recurrence may occur even beyond 1 year hence, a longer follow up period would be advisable.

Analysis of Sturge Weber Syndrome: A Retrospective Study

Background: To review the clinical manifestations and neuroimaging features of patients with Sturge-Weber syndrome(SWS) treated at a tertiary care centre over a 3 year period. Methods:A retrospective study of six patients with SWS (4 males and 2 females) was conducted. Data was collected by reviewing the clinical histories of patients diagnosed with SWS over the last 3 years. Results: All patients had port-wine stain (PWS) involving the eyelid. Glaucoma was the main ocular disease being diagnosed in 2 eyes of three patients (66.66%). Five patients (83.33%) had neurological impairment including seizure, hemiparesis, headache, and delayed development. However, the most common neurological manifestation was epilepsy (83.33%), which could be controlled with antiepileptic drugs. In neurological imaging intracranial abnormalities were demonstrated which included cerebral atrophy (75.0%), cerebral calcification (50.0%), leptomeningeal angioma (25.0%), and enlarged choroidal plexus (25.0%). The ocular complications and intracranial abnormalities were usually ipsilateral to the PWS.. Conclusion: Port-wine stains, glaucoma, and seizure were the most common clinical presentations of Sturge-Weber syndrome detected in this study. Complete ophthalmic and neurological evaluation should be performed at the time of diagnosis

TBARS level in socioeconomical poor rural sickle cell patients of Bilaspur Zone of Chhattisgarh State.

Sickle cell disease (SCD) is an inherited disorder of hemoglobin synthesis and the oxidative stress has major role in the pathogenesis of SCD. Thiobarbituric acid reactive substances formation by lipid peroxidation is a marker of oxidative damage in membrane.The study was under taken to measure the oxidative stress in sickle cell patients of Chhattisgarh rural population because of low natural antioxidants in their diet. The patients of sickle cell anemia group (homozygous, n=9) and sickle cell trait (heterozygous, n=21) shows TBARS level 2.28±0.66μM/l and 2.23±0.7μM/l respectively as compared to control (without S.C.D) 1.25±0.41μM/l. the study shows TBARS concentration is approximately double in sickle cell disease than control.

Localization of mycobacteral smegmatis adenosine deaminase.

The study was carried out to check the localization of M.smegmatic adenosine deaminase for its metabolic and clinical importance. The separation and washing of the membrane was done by using refrigerated high-speed centrifuge. The high activity was observed in crude extract while low activity in first washing of the membrane but after second washing there was no enzyme activity seen. Culture media also does not show any enzyme activity. Thus M.smegmatic adenosine deaminase may be a cytosolic enzyme and it does not excreted in to the surrounding media.

Hematological profile of sickle cell disease: A hospital based study at CIMS, Bilaspur, Chhattisgarh.

Hematological profile of total 1260 individuals were tested for Sickle Cell Disease who attended CIMS OPD, Bilaspur during a period of May 2008 to October 2009 is presented here. At least 4.44% of the total subjects tested were identified as homozygous for sickle cell gene (SS) and 35% were with sickle cell trait (AS). The patients were confirmed by examining the blood samples for solubility test and hemoglobin electrophoresis using cellulose acetate membrane. Among the SS patients about 58% were males and 42% were females and their ages vary from 7 months to 65 years. The SS patients showed comparatively low level of hemoglobin as well as the RBC count in both the sexes than the AS or normal subjects (AA). PCV was higher in males (31.44±3.1%) than in females (28.62±3.6%). Average MCH and MCHC did not show any significant difference between the sexes. MCV and MCHC were found to be quite higher in SS subjects than AS or AA. Thus in absence of any definite data this investigation may put some insight on the incidence of sickle cell disease in Chhattisgarh.

Significance of gammaglutamyl transferase estimation in hepatobiliary diseases.

The present study was conducted to evaluate the significance of gamma glutamyl transferase (GGT) in hepatobiliary diseases and made to prove the GGT as a significant differential factor in diagnosis of high serum alkaline phosphatase conditions. In 166 patients of hepatobiliary diseases.The results were compared with 32 healthy age matched volunteers, patients were subjcted to detailed clinical examination and laboratory investigations. Blood samples were collected for estmation of serum Bilirubin, AST, ALT, ALP and GGT. Ratio of serum AST/ALT and serum ALP levels were significantly (P<0.001) increased in alcoholic liver disease and hepatic carcinoma. The results give enough evidence of increased GGT in microsomal induction by alcohol and other factors.

Primary pterygium surgery –comparsion of limbal conjunctival autografting versus intra- operative mitomycin-C.

Pterygium is a fibro vascular encroachment of the conjunctival tissue on to the cornea, causing variable degree of ocular morbidity. Various surgical modalities have been developing to decrease the recurrence. The idea of study is to compare the relative efficacy of two well known procedures i.e. conjunctival autografting and intra-operative Mitomycin –C (0.02%) with reference to recurrence and complication rate.

Conventional dacryocystorhinostomy versus endonasal dacryocystorhinostomy:a comparative study.

The objective of present study was to compare the results of endonasal endoscopic dacryocystorhsrtostomy and external dacryocystorhinostomy. It was a prospective non-randomized study. forty corsecutive patients having complaints of watering with complete naso lacrimal dact obstruction were selected for the study. Dacryocystography was done in all the cases. Selection of type of operation was left to the patient’s choice. All patients had preoperative counseling and both the procedures were explained in detail with their advantages and disadvantages. Twenty patients underwent endonasal dacryocystorhinostomy and twenty had external dicryocystorhinostomy Silicon intubation was done in all cases of endonasal dacryocystorhinostomy for three months after surgery. The final follow-up was done at 12 months after surgery. The patency of lactimal passage was confirmed by syringing and patients were questioned about their symptoms. There was no significant difference in the results of both surgeries. The complication rate in both groups was almost equal. Thus we came to the conclusion that these two different dacryocyatorhinostomy techniques are acceptable alternatives.

Carotid cavernous sinus fistula presenting with pulsating exophthalmos and secondary glaucoma.

Carotid cavernous sinus fistula is abnormal communications between the carotid arterial system and the venous cavernous sinus. Carotid cavernous sinus fistula can develop either because of trauma or spontaneous causes. Spontaneous carotid cavernous sinus fistula is often associated with a pre-existing aneurysm in the intracavernous portion of internal carotid artery. However, these fistulas may be congenital arteriovenous connections that open spontaneously in the settings of collagen vascular disease, atherosclerosis, hypertension, or may develop in females during peripartum period. A case of spontaneous carotid cavernous sinus fistula in a young adult male who presented with pulsating exophthalmos and secondary glaucoma is presented. Characteristic features of arteriovenous fistula--bruit, thrill, corkscrew episcleral vessels were present. Radiological investigations were done to confirm the diagnosis. Transvenous embolisation was done to close the fistula.

Levels of erythrocyte malonyldialdehyde, vitamin E, reduced glutathione, G6PD activity & plasma urate in patients of pregnancy induced hypertension.

To assess the oxidative stress across the cell membrane in patients suffering from pregnancy induced hypertension, erythrocyte malonyldialdehyde, vitamin E, reduced glutathione, glucose-6-phosphate dehydrogenase activity and plasma urate levels were estimated in 25 non pregnant women, 40 normotensive pregnant women and 40 women with pregnancy induced hypertension (PIH). As compared to non pregnant women, there was a significant increase in the levels of erythrocyte malonyldialdehyde and plasma urate in normotensive pregnant women, which were further increased in women with PIH. Erythrocyte glutathione levels were raised in normotensive pregnant women as compared to non pregnant women. Its levels were decreased in patients of PIH as compared to normotensive pregnant women. Cellular bio-availability of vitamin E was depressed in both normotensive pregnancy as well as patients with pregnancy induced hypertension as compared to non pregnant women.